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Pursuant to a congressional request, GAO reviewed the effectiveness of efforts to assist homeless veterans, focusing on: (1) describing the Department of Veterans Affairs (VA) homeless programs; (2) determining what VA knows about the effectiveness of its homeless programs; and (3) examining promising approaches aimed at different groups of homeless veterans.

GAO noted that: (1) VA's homeless assistance and treatment programs address diverse needs of homeless veterans by providing services such as case management, employment assistance, and transitional housing; (2) VA also provides medical, mental health, substance abuse, and social services to homeless veterans through its hospitals, outpatient clinics, and other health care facilities; (3) because of resource constraints and legislative mandates, VA expanded its homeless veterans efforts by better aligning itself with other federal departments, state and local government agencies, and community-based organizations; (4) the goal of this effort is to develop a continuum of care for the homeless--that is, to identify or create options for addressing the full array of housing, health, and service needs of this population; (5) VA has little information about the effectiveness of its homeless programs; (6) VA has relied on the Northeast Program Evaluation Center (NEPEC) to gather and report information about its homeless programs; (7) each of VA's homeless program sites routinely submits extensive data, mostly related to client characteristics and operations at individual program sites; (8) these data are used primarily to provide program managers with information about service delivery and are of limited use in assessing program effectiveness; (9) to evaluate effectiveness, information must be gathered about intended program results; (10) the outcome measures that NEPEC uses focus on housing, employment, and changes in substance abuse and mental health at the time veterans are discharged from VA's homeless programs; (11) little is known about whether veterans served by VA's homeless programs remain housed or employed, or whether they instead relapse into homelessness; (12) many questions about how to treat homelessness remain unanswered; and (13) experts agree, however, that a comprehensive continuum of care for the homeless--such as that which VA is striving to achieve--should include a range of housing and service alternatives, with specific approaches at any one site reflecting local needs and local resources.

Recommendation for Executive Action

Status: Closed - Not Implemented

Comments: VA has focused its evaluation efforts on current or planned programs that are targeted to specific subsets of homeless veterans, rather than its core homeless programs. For example, VA has recently begun implementing several new programs for specific groups of homeless veterans; outcome data will be collected for these new programs. VA has indicated its intention to compare the data it collected previously from core VA homeless programs to data that are currently being collected through a project spearheaded by the Department of Health and Human Services. VA has not indicated an intention to conduct additional program evaluation studies of its core homeless programs.

Recommendation: The Secretary of Veterans Affairs should direct the Under Secretary for Health and the Assistant Secretary for Planning and Analysis to collaborate on conducting a series of program evaluation studies to clarify the effectiveness of VA's core homeless programs and provide information about how to improve those programs. Where appropriate, VA should make decisions about these studies (including the type of data needed and the methods to be used) in coordination with other federal agencies with homeless programs, including the Department of Health and Human Services, the Department of Housing and Urban Development, and the Department of Labor.